Protein restriction in hepatic encephalopathy is appropriate for selected patients: a point of view.
Protein restriction in hepatic encephalopathy is appropriate for selected patients: a point of view.
复制标题
肝性脑病的蛋白质限制适合特定的患者：一种观点。
DOI：
10.1007/s12072-013-9497-1
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发表时间：
2014
影响因子：
6.6
通讯作者：
Morgan,Timothy
中科院分区：
文献类型：
--
作者：
Nguyen,DouglasL;Morgan,Timothy
自世纪后期以来，蛋白质限制已被证明可以改善肝性脑病。然而，营养不良已被描述在高达60%的腹泻患者中，并且与死亡率增加相关。此外，新出现的临床证据表明，大部分的糖尿病患者可以耐受正常的蛋白质摄入。然而，大约三分之一的肝性脑病患者可能需要短期的蛋白质限制，除了最大限度的药物治疗，以改善其肝性脑病的临床过程。对于蛋白质敏感的慢性肝性脑病患者，通过使用更多的植物蛋白、更少的动物蛋白和支链氨基酸来改变他们的氮源可能会改善他们的脑病，而不会进一步损失瘦体重。总之，在肝性脑病患者中，正常蛋白质摄入量的调整必须考虑到患者的肝脏储备、肝性脑病的严重程度和当前的营养状况。
Since the late nineteenth century, protein restriction has been shown to improve hepatic encephalopathy. However, malnutrition has been described in up to 60 % of cirrhotic patients and is associated with increased mortality. Furthermore, emerging clinical evidence has revealed that a large proportion of cirrhotic patients may tolerate normal protein intake. However, approximately one third of cirrhotic patients with hepatic encephalopathy may need a short course of protein restriction, in addition to maximum medical therapy, to ameliorate the clinical course of their hepatic encephalopathy. For patients with chronic hepatic encephalopathy who are protein-sensitive, modifying their sources of nitrogen by using more vegetable protein, less animal protein, and branched-chain amino acids may improve their encephalopathy without further loss of lean body mass. In conclusion, among cirrhotics with hepatic encephalopathy, modulation of normal protein intake must take into account the patient’s hepatic reserve, severity of hepatic encephalopathy, and current nutritional status.